Individual
DR. MOHAMMAD M. SHABAHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 E MAIN ST, WAYNESBORO, PA 17268-2332
(717) 217-6800
(717) 839-2807
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
BS3301291
PA
208600000X
Surgery Physician
Primary
MD439990
PA
2086X0206X
Surgical Oncology Physician
L4705
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102488460
—
PA
01
—
13822314
CAQH
—
05
—
1527996-01
—
TX
01
—
1527996-02
CSHCN
TX
01
—
8G5390
BLUE SHIELD
TX
Enumeration date
03/31/2006
Last updated
02/09/2024
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